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T 1x3((A <br />tHx� <br />AC n <br />o:z 0 <br />{ H 'U <br />(A H <br />1-3 <br />HZ <br />Q <br />� s o <br />O <br />�ctillg <br />�yHH <br />O�H <br />0 C CA <br />HOtoo <br />'1 <br />APPLICATIG64 FOR L' 43NSTRUC7 mON PERMIT <br />OwEwrown <br />CITY OF <br />everrtt <br />BUILDING DEPARTMENT 259-8810 TO BE COMPLETED IN INK —PLEASE PRINT <br />_CI DEMOLITION O COMBINATION BUILDING MECHANICAL <br />O'YNER MAR ADDRESS CITY - '.1 PHOLIE <br />T A G 1NVESTrgL- c 0� boy 17N(v C/CII�TI IAl9 yKao(0 3� <br />L ,e Purwv <br />PLUMBING SIGN <br />MECHANICAL CONTRACTOR MAX ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAX ADDRESS CITY ZIP <br />Ss OF YWXM <br />NEW 1 1 ADDITION ❑ ALTERATION REPAIR <br />LICENSE F <br />❑ DEMOLITION I l WOODSTOVE/FRPL INSERT D BUILDING RELOCATION <br />TENANT IMPROVEMENT OR INTERY.A REMODEL(1M� Co CONTACTPERSONANDPHONENO <br />so.. V �l f.. rQ 1'1 cz S -ntr mu I L7i2 - 4S5 -�,.54 q <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />BUILoTN(o P6* -Ntw TILT -UP arvsuZUCt1o4 47 S9 <br />_ <br />PROPnsED USE OF SUMMING <br />MAW/"r d AC, MO & <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLIC 70N AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONSOF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORI(Y TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PrOPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 ROW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X1� . UI�_ sco MIL Cr2c H rrrcrs <br />LEGAL DESCRIPTION OF PROPERT.-IBI10vm SEEM OR ATTACH FOUR COPIES) <br />LOT C�ta" 23 BLOCK OF (.y <br />2 <br />(3e" 4 1J0. <br />PRO ECTADDRESS �' (- (r- t <br />a- T U VP tT 1 <br />µ, L <br />Ct) CL/VEIIµ <br />APPLICANTS CITY BUSINESS LICENSE NO AND WSINESS NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET( <br />A/C—AMNOLG UNITS—H.P. <br />I <br />9ATHTU8 <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY(WA3H BASIN) <br />UNIT HEATERS—B.T.U. M <br />I <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />' <br />_ <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />I <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />' <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />' <br />ROOF DRAINS—RA!NLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />i <br />I <br />SUBTOTAL <br />S <br />i <br />SUBTOTAL S <br />' <br />PERMIT <br />S <br />PERMIT $ <br />TOTAL FEE <br />S <br />' <br />TOTAL FEE $ <br />' <br />FRONT SETBACK <br />ROAR SETBACK <br />BIDE SETBACK <br />N <br />C NUMBER_ <br />�237 <br />FEE�yY <br />�/iVAA1LLUUA/TION <br />REC(M� NOI� <br />`x�L,FEE <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />( I YES NO <br />FEES <br />BUILDING <br />PLUMBING <br />-4 <br />TYPE OF COST. ALLOWABLE <br />,� IV— <br />TYPE qmlACTUAL <br />T/ <br />� � <br />IQ OLYXL aIAunle <br />SIZE OF BLDG. <br />'1—i <br />NO OF STORIES <br />BASEMENT <br />1 YES Pe NO <br />MECHANICAL <br />' <br />OTHERnh <br />I <br />OCC ANCY FIRE SPRNKLERS REO'D <br />5 ' >C1 ES NO <br />REASON FOR SPRINKLERS <br />HEIGHT LIMITATION <br />—� <br />STATE BIJILDING <br />SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATIONACC BY <br />PLANS APPROVED BY <br />/ <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />i <br />, <br />1 TOTAL <br />